This Seems To Be A Very Interesting And Innovative Approach. I Wonder Where It Might Lead.

The Substitutable Medical Applications, Reusable Technologies (SMART) platform appears to be a "promising approach" to improve electronic health records now that phase one of the project has been completed, according to its developers.

The creators report[1] this week in the Journal of American Medical Informatics Association that unlike current proprietary EHR systems, the SMART platform operates as a standard base platform to which users can add or subtract modular third-party applications, similar to the methodology used by iPhone or Android.

The researchers noted that in just 14 months, they have developed "containers"--such as EHRs and health information exchanges and charter applications--to showcase the system's capability.

"With the cost of switching kept low, the platform enables a physician using an EHR, a Chief Information Officer running a hospital IT infrastructure, or a patient using a personally controlled health record (PCHR) to readily discard an underperforming app and install a better one. Competition on quality, cost, and usability is enabled, and the pace of innovation increases," the developers said.

Materials and methods The Office of the National Coordinator for Health Information Technology, through the Strategic Health IT Advanced Research Projects (SHARP) Program, funds the project. The SMART team has focused on enabling the property of substitutability through an app programming interface leveraging web standards, presenting predictable data payloads, and abstracting away many details of enterprise health information technology systems. Containers—health information technology systems, such as electronic health records (EHR), personally controlled health records, and health information exchanges that use the SMART app programming interface or a portion of it—marshal data sources and present data simply, reliably, and consistently to apps.

Results The SMART team has completed the first phase of the project (a) defining an app programming interface, (b) developing containers, and (c) producing a set of charter apps that showcase the system capabilities. A focal point of this phase was the SMART Apps Challenge, publicized by the White House, using http://www.challenge.gov website, and generating 15 app submissions with diverse functionality.

Conclusion Key strategic decisions must be made about the most effective market for further disseminating SMART: existing market-leading EHR vendors, new entrants into the EHR market, or other stakeholders such as health information exchanges.

The idea of developing iPad and Android like apps for a Health Information Source is an interesting one. If such an approach can generate one thousandth of the innovation we have seen in those apps in the Health Information space all our Christmases may have come at once!